The first, gua, means to rub or to scrape, and the second, sha, is the name given to the distinctive type of red dotting and discoloration that appears at the skin surface during and after treatment. Gua sha therefore means to rub out sha.

Gua sha is typically performed by rubbing a smooth-edged instrument across the skin surface where a subcutaneous injury or imbalance resides. When treatment is effective, distinctive reddening of the skin, known as sha, is observed. This is a positive response and brings the immediate and lasting benefit of dispelling wind, reducing heat and inflammation, eliminating coldness, and releasing pain from the superficial and deeper levels of the body.

Gua sha is used to treat many acute and chronic health problems including colds and flu, fever, headache, indigestion, dizziness, injury, joint pain, fibromyalgia and heat exhaustion. It is also commonly performed to relax tight and aching muscles and to relieve tiredness and fatigue, emotional stress. The stroking action of gua sha to the points and channels can also be practiced as a health enhancement method, and can even be performed through light clothing (without the intention of raising sha).

Gua sha is applied primarily on the back, neck, shoulders, buttocks and limbs. Thicker oil is spread over the area to be rubbed. The instrument is held comfortably in the hand and the practitioner usually makes 10 to 30 strokes in a downward direction away from the head. A simple measure to be certain the force used is correct is to ask the person receiving if they are comfortable with the pressure. For best results, gua sha is emphasized on both local and distal acupuncture points determined by diagnosis.

After gua sha:Allow the receiver to rest for a while and give him or her a glass of warm water.Instruct the receiver not to shower or bathe within one hour after treatment. A cold water shower or bath should be avoided for at least 24 hours.Inform the receiver it is important to keep all treatment areas covered up and warm. They should also be sure to keep away from windy conditions including fans and air-conditioning.

Cautions and contraindications:Take care to avoid pimples, moles and other skin irregularities that may be scratched or broken if an instrument is rubbed over it. Care must also be taken to rub the area with appropriate pressure. The first rule of any therapeutic procedure is DO NO HARM.

Do not apply gua sha:To people who are too weak to tolerate the treatment.To people with bleeding disorders.To people who are taking anti-coagulant medication, eg. warfarin.During pregnancy.Soon after surgery.Over varicose veins, skin disease or open wounds, scratches etc.To a person suffering from a serious communicable disease.Within one hour before or after eating.